Mahsa A le-ebrahim - Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran

Cardiovascular diseases (CVDs) accounts for 30% of deaths worldwide, including nearly 40% in high-income countries and about 28% in low- and middle-income countries. There was a remarkable growth in scientific publication on personalized medicine within the past few years in the cardiovascular field. We can classify personalized medicine into comprehensive, genomics, structural and functional fields. Examples of functional factors include endothelial function, exercise testing, and heart rate variability. Endothelial dysfunction is a novel target for CVDs risk reduction and therefore is of great interest to interventionists. The endothelium regulates vascular tone through releasing several vasoactive substances, like nitric oxide. The nitric oxide mediates the protection of the endothelium by limiting the vascular inflammation, vascular smooth muscle proliferation, platelet aggregation, and tissue factor production. Endothelial function can be tested by flow-mediated dilation (FMD) in the brachial artery. The treatment of coronary heart disease reverses endothelial dysfunction, including drugs that modify lipids and reduce blood pressure, along with smoking cessation, physical exercise, and dietary intervention. One of the alternative methods for measuring endothelial function is the noninvasive peripheral arterial tonometry that examines the endothelial dysfunction and can predict late cardiovascular events. The Reactive hyperaemia (RH) response with peripheral arterial tonometry as detected by the RH index is another useful technique for detecting the CVDs and it has been shown to be related to multiple traditional and metabolic risk factors. Also, pulse amplitude tonometry (PAT)-derived measures of arterial stiffness (augmentation index, AI) had strong repeatability. These functional fields of personalized medicine can help cardiologists to diagnosis the endothelial dysfunction and prevention of causing CVDs.

Cardiovascular diseases, personalized medicine, Endothelial function, peripheral arterial tonometry